Term Paper: Validating the Effectiveness of Participation

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Shelov says that the healing process calls for a child to remember over and over, detail by detail. Children remember through retelling, through play, and through their post traumatic fears, dreams and unusual behaviors. All of these varied forms of remembering are indications of the trauma's force but which are also part of the child's internal struggle to heal and master the trauma.

Shelov stresses that trauma causes psychological wounds. Healing from the wounds requires time and can be influenced by understanding parents and other caregivers. Different children manifest different signs of psychological trauma. There is a correlation between particular aspects of the trauma itself and all that is special and characteristics about the child to bring about a child's particular response to the trauma. Parents and caretakers should be very observant during the following weeks and months to discover the effect of the experience on the child. We must remember that young children may not be able to discuss what has happened and may communicate what they have experienced through play and changes in normal routine behavior.

Children don't react to psychological trauma in the same way and at the same time. Some children react to psychological trauma immediately, some within a few days after the assault. However, some children don't show any signs of immediate reaction; they appear untouched, unaffected, unfazed, they appear to show no signs of fear. Some studies show though that these unaffected children will manifest distress signs as delayed reactions over time. Children's distress will appear in unusual behavior and reactions, some of which are the following:

Fears and anxieties. Persistent fearfulness, specific phobias, unspecified fears, heightening distress over separation from caretakers, and sudden and swift reaction to loud noises

Behavioral regression. Children's reaction are manifested by a temporary setback in skills and behaviors expected of their age level. They may show lack of developmental skills, they tend to lose control over aggression and inability to control themselves.

Children may imagine unwanted images and thoughts. They may repeatedly describe disturbing images of the trauma in their minds.

Inability to enjoy pleasurable activities

Repetition in describing the trauma, replaying the trauma

Withdrawal from parents, caretakers, friends, playmates

Sleep-related difficulties

Changes in personality

Complaints of aches and pains

Accident-proness and recklessness.

These are signs of trauma and stress to watch out for. These may be the only indicators of a child's distress. The child's behavior indicates a problem that the child is trying to cope with. The child's success in coping with the trauma is often dependent on a parent's or caregivers ability to accept the symptoms of the problem and remedy them. Once the behavior and attitudes are understood and accepted, the child's recovery becomes clearer and easier.

Shelov insists that the kind of trauma generally has a direct impact on the severity of a child's reaction. Single traumatic events of short duration that do not involve interpersonal violence or threat often have less serious and brief effect than events that result in physical harm, lasting disfigurement, major changes in the child's family and life circumstance or other constant reminders of the trauma.

Shelov describes the healing process that should be prescribed for a child who feels that the mantle of protection on his being has been destroyed. For a while he loses his prior sense of security from harm. It is not just fantasies and bad dreams that haunt him, it is real life that must be feared. Threatened children undergoing a psychological trauma look towards his protective parents and trusted adults for reassurance and support. Sometimes, parents too are traumatized and they feel that they have little to give to the child by way of reassurance and support. They first need to be treated themselves.

Shelov lists down ways by which children may be helped.

1. Following a child's encounter with trauma, for many months, children need lots of comforting and reassurance. Infants and young children need to be nursed, rocked-cuddled, sung to. They need stories to listen to and to quickly read. The child needs to return to those comforting rituals that soothed it when it was younger. Older children's needs and likes must be considered when parents try to comfort them. Parents know what is particularly soothing to their child. Children need to be calmed and special comforting at bedtime is called for, maybe an extra story, a massage, a nigh light, imagining good dreams to have, a favorite music on a tape recorder or favorite stories. Comfort and reassurance are needed by children having nightmares. The source of terror should be directly addressed and eliminated.

2. Children should be given basic information about what happened to them. Information that could be understood by the child told simply and honestly, questions answered directly and truthfully.

3. Tolerance for regression behavior. Parents' response when a child regresses needs to match the needs of the child. The child should be made to feel that the parents understand that the child is undergoing difficulty and that the parents and child can handle the problem together until the child is stronger again.

4. Respect a child's fears. The fears should be acknowledged, that they will be less frightening overtime and that you will be present to help them. There is the danger of giving a child's fears too much support. Out of fear and concern, parents can miss signs that the child is ready to move on. Finding the middle course between over-protectiveness and excessive expectations is the most difficult but the best route.

5. Children who are undergoing flashbacks and panic reactions can be comforted by immediate reassurance and education. Children must be brought to the present. The parents can talk to the child about the here and now, making the child feel that the danger is over and that she is not alone. Children should be reminded that they are safe now.

6. Opportunities should be provided about talking about feelings. Children very often exhibit strong feelings, many of them unpleasant and upsetting. Telling and talking about the unpleasant incident is definitely part of the healing.

7. Opportunities should be provided for play. Playing out the trauma is necessary for many children. Appropriate toys and props should be available to the child for play experiences.

8. Be ready for difficult behavior. Children's own controls fail them. They cry over little things, make angry demands, show more aggression and test limits and rules. It is difficult for parents to respond to this behavior. Parents should show understanding and caring while maintaining the rules and limits of the home.

9. Follow the normal routine as quickly as possible. Children find comfort when they returning to normalcy.

10. There should be physical outlets for children having difficulty in controlling their aggressiveness.

11. Focus on images of strength and survival. Both parents and children should be reminded of their strengths and competencies. Let them be reminded of difficulties they have overcome in the past.

When is the time to seek professional help?

There are definite signs that call for immediate professional help. Shelov lists them down as follows:

1. A child's post traumatic behavior endangers herself and others.

2. A child reacts to the trauma by talking about being dead, dwelling on the issues of death and dying or threaten to commit suicide.

3. The child loses all prior grasp on the line between fantasy and reality.

4. There are disruptions in daily life and age-appropriate behaviors.

Indicators which can be expected during the initial stage of coping with trauma become causes for worry if they persist or intensify. The following behaviors lasting beyond six weeks are reasons for seeking professional help:

1. The child continues to experience extremes of fear, nightmares, flashbacks, and separation anxiety.

2. The child's regression to the behavior of a younger child shows no sign of decreasing over time.

3. The child continues to experience more than one nightmare per week or shows no decrease in other sleep disturbances originating at the time of the trauma.

4. There is no decrease in social withdrawal, listlessness or lack of pleasure in routinely enjoyable activities over six weeks.

5. The child complains continuously of physical pain or illness for which no medical explanation can be found. This can mean underlying unexpressed emotional pain.

6. A child continues to undergo vivid terror in response to trauma-related sensory triggers with no decrease in intensity or frequency of these reactions.

7. A child's distractibility interferes with attention and learning at school.

8. Overall changes in the child's personality dating from the time of the trauma that are dramatic and worrisome to parents and others.

9. The child's post-traumatic reaction or behavior even if mild, is particularly upsetting or bothersome to the child.

Time is of the essence in seeking professional help. The earlier the traumatized children go for professional help, the better the chances that these children will benefit from the help. The… [END OF PREVIEW]

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